Louisiana State University LSU Digital Commons LSU Historical Dissertations and eses Graduate School 2001 e Effect of Psychotropic Medications on Social Skills in Persons With Profound Mental Retardation. Jerald Wayne Bamburg Jr Louisiana State University and Agricultural & Mechanical College Follow this and additional works at: hps://digitalcommons.lsu.edu/gradschool_disstheses is Dissertation is brought to you for free and open access by the Graduate School at LSU Digital Commons. It has been accepted for inclusion in LSU Historical Dissertations and eses by an authorized administrator of LSU Digital Commons. For more information, please contact [email protected]. Recommended Citation Bamburg, Jerald Wayne Jr, "e Effect of Psychotropic Medications on Social Skills in Persons With Profound Mental Retardation." (2001). LSU Historical Dissertations and eses. 393. hps://digitalcommons.lsu.edu/gradschool_disstheses/393
110
Embed
The Effect of Psychotropic Medications on Social Skills in ...
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Louisiana State UniversityLSU Digital Commons
LSU Historical Dissertations and Theses Graduate School
2001
The Effect of Psychotropic Medications on SocialSkills in Persons With Profound MentalRetardation.Jerald Wayne Bamburg JrLouisiana State University and Agricultural & Mechanical College
Follow this and additional works at: https://digitalcommons.lsu.edu/gradschool_disstheses
This Dissertation is brought to you for free and open access by the Graduate School at LSU Digital Commons. It has been accepted for inclusion inLSU Historical Dissertations and Theses by an authorized administrator of LSU Digital Commons. For more information, please [email protected].
Recommended CitationBamburg, Jerald Wayne Jr, "The Effect of Psychotropic Medications on Social Skills in Persons With Profound Mental Retardation."(2001). LSU Historical Dissertations and Theses. 393.https://digitalcommons.lsu.edu/gradschool_disstheses/393
This manuscript has been reproduced from the microfilm master. UMI films
the text directly from the original or copy submitted. Thus, some thesis and
dissertation copies are in typewriter face, while others may be from any type of
computer printer.
The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper
alignment can adversely affect reproduction.
In the unlikely event that the author did not send UMI a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized
copyright material had to be removed, a note will indicate the deletion.
Oversize materials (e.g., maps, drawings, charts) are reproduced by
sectioning the original, beginning at the upper left-hand comer and continuing
from left to right in equal sections with small overlaps.
Photographs included in the original manuscript have been reproduced
xerographically in this copy. Higher quality 6" x 9* black and white
photographic prints are available for any photographs or illustrations appearing in this copy for an additional charge. Contact UMI directly to order.
ProQuest Information and Learning 300 North Zeeb Road. Ann Arbor, Ml 48106-1346 USA
800-521-0600
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
THE EFFECT OF PSYCHOTROPIC MEDICATIONS ON SOCIAL SKILLS IN PERSONS
WITH PROFOUND MENTAL RETARDATION
A Dissertation
Submitted to the Graduate Faculty of Louisiana State University and
Agriculture and Mechanical College in partial fulfillment o f the
requirements for the degree of Doctor o f Philosophy
in
The Department o f Psychology
byJerald W. Bamburg, Jr.
B.S., Belmont University, 1993 M.S., Northwestern State University, 1995
December, 2001
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
UMI Number: 3042609
___ ®
UMIUMI Microform 3042609
Copyright 2002 by ProQuest Information and Learning Company. All rights reserved. This microform edition is protected against
unauthorized copying under Title 17, United States Code.
ProQuest Information and Learning Company 300 North Zeeb Road
P.O. Box 1346 Ann Arbor, Ml 48106-1346
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
ACKNOWLEDGMENTS
Dr. Johnny L. Matson
Dr. Drew Gouvier
Dr. Katie Cherry
Dr. William Waters
Dr. Amy Copeland
Jerald W. Bamburg, Sr.
Jeanette Bamburg
Dr. Stephen Anderson
Dr. Brandi Smiroldo
Rhonda Bamburg Grady
Brenda Tucker
Dr. Victoria Swanson
Dr. James R. Logan
Dr. C. Scott Eckholdt
ii
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
SOCIAL SKILLS............................................................................ 18Definitions............................................................................ 19Social Skills and Mental Retardation................................. 24Assessment o f Social Skills.................................................27
PSYCHOPHARMACOLOGY AND MENTALRETARDATION....................................................................37Pharmacology and Behavior Problems................................. 39Pharmacology and Psychiatric Illness ........................43Side-Effects............................................................................. 49Overview...................................................................................50
RATIONALE FOR THE STUDY..................................................... 52
(* ) ind ica tes s ig n ifican t d iffe re n ces a t g < 0 5 be tw een T im e I an d T im e 2 for each variab le pair.• •M E S S IE R P o sV er = P ositive V erbal S u b sc a le ; M E S S IE R P osN on = P ositive N o nverba l S ub sca le ; M E S S IE R G enP os= G en era l P ositive S u b sc a le ; V 'A BS C o m m = C o m m u n ic a tio n D om ain , V A B S D aily = D aily L iv ing S k ills D om ain ; V A B S S ocia l = S o c ia liza tion D om ain**
72
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Discussion
A relationship appears to exist between medication regimes and social and
adaptive skills in persons with profound mental retardation. Additionally, persons in
this sample experienced a decrease in social and adaptive behavior as a function o f time
and medication regime. Finally, individuals in this sample were differentiated on
measures tardive dyskinesia as a function of particular medication classifications.
Individuals receiving medication regimes consisting of traditional or atypical
antipsychotic medications had consistently less social and adaptive skills than those
receiving other medications or experimental controls. The same groups also
experienced decreases in social and adaptive behavior after receiving particular
medications a minimum of three years. Lastly, individuals in the sample who received
traditional antipsychotic medications had significantly higher scores o f measured side-
effects than other medication classes or experimental controls. Demographic variables
did not reveal differential response on MESSIER or VABS subscales based on age,
race, gender, deafness, blindness, or ambulation. Findings are discussed in greater
detail below.
The first manipulation check stated that there would be no statistically
significant differences between demographic variables for the five groups. Given the
stringent matching techniques utilized in comprising this sample, it was no surprise that
no differences were found with regard to groups or skill level as a function of
demographic variables.
73
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
The second manipulation check stated that social and adaptive skills scores
would not be differentiated by demographic variables. No significant differences were
found in these analyses. It was surprising that the variable related to age did not
produce differences in social and adaptive functioning as well as measured side-effects.
One might expect that persons who are of advanced age would have longer history of
psychotropic medication use resulting in lower levels o f adaptive skills and a higher
prevalence o f tardive dyskinesia. However, the current findings did not support this
idea, and these results may suggest that skill deterioration is similar for individuals who
have received medication for periods of time surpassing three years. However, further
research is needed before conclusions of this nature can be reached.
Other variables that could have certainly influenced level of social and adaptive
skill include verbal skills, ample eyesight, and level o f ambulation. In a more diverse
population of persons with mental retardation, these variable would probably have been
more predictive o f differences in skills and abilities. However, given the fact that this
sample was comprised solely of persons with profound mental retardation and matched
stringently, these variables did not prove predictive o f differences in social and adaptive
skills.
The first hypothesis, which stated that social and adaptive skills would
be differentiated by specific medication class, was supported. Individuals
receiving medication regimes including atypical or traditional antipsychotic
medications had significantly less social and adaptive skills than persons receiving anti
epileptic medications or experimental controls. Interestingly, persons receiving
74
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
traditional antipsychotics, atypical antipsychotics, and multiple medications were not
differentiated by MESSIER subscale scores but were differentiated by communication,
daily living, and socialization domains of the VABS. This finding is probably
explained by the difference in specificity and skill level required between the two scales
(MESSIER and VABS) and further suggest that the scales are measuring different
constructs.
Another interesting finding was noted with regard to persons receiving anti
epileptic medication. Individuals receiving this class o f medication alone demonstrated
more social and adaptive behaviors than persons in groups containing antipsychotic
medication regimes but a significantly lower skill level than experimental controls.
While the literature for psychotropic drugs and mental retardation has not stressed the
impact of anti-epileptic medications on social and adaptive behavior, it does appear that
these medications can be detrimental to social performance. It could be that the feelings
o f sedation and physical discomfort often associated with anti-epileptic medications are
paramount in decreasing social behavior; however, further research in this area is
certainly needed before conclusions may be reached. Whatever the nature o f the
relationship, these findings indicate that anti-epileptic medications certainly affect the
development and presentation o f prosocial behavior.
Current findings are consistent with past literature concerning medication
effects on prosocial behavior and learning in persons with mental retardation.
Antipsychotic medication, in both the traditional and atypical classes, has consistently
suppressed behavioral repertoires (appropriate and maladaptive) in persons with mental
75
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
retardation (Gedye, 1998; Dent, 1995; Diaz, 1996). However, these medications do not
appear viable as first line treatments for behavior problems due to the adverse impact
they have on the individual’s spectrum of positive behavior. The current findings
support this idea, as persons receiving traditional or atypical antipsychotics had
significantly fewer social and adaptive skills. There are clearly those cases when
antipsychotic medications are not only indicated but necessary in treatment regimes.
First, when psychosis is clearly observed and diagnosed, antipsychotic medications are
needed for appropriate and effective treatment. Additionally, antipsychotic medications
may be indicated for conditions not responsive to other behavioral and pharmacologic
treatments. However, these latter cases are few and far between, and prescriptions for
medications in this class for problems other than true psychosis should be avoided in
most cases (Matson et al., in press).
Much of the same is true for persons receiving anti-epileptic medications
(AEDs). While current results indicated that AEDs were not as behaviorally
suppressing as the antipsychotic class, they clearly had a significant negative impact on
prosocial behavior. While the exact mechanism causing these differences is unknown,
it has been hypothesized by many that the sedating properties and stomach discomfort
caused by AED use is the culprit in decreased attention, engagement, learning and
social behavior (Taylor et al., 1991; Walters et al., 1990). There are those conditions in
which medications in this class are necessary for effective treatment. Besides seizure
disorders and epilepsy, manic behavior has been shown to respond positively to anti
epileptic medications. However, the most common psychiatric usages of these
76
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
medications include impulse control problems and aggression. Ironically, research has
not indicated the effectiveness o f this class in either condition in persons with mental
retardation. Therefore, this practice should probably be avoided except in the most
extreme cases.
The second hypothesis, which predicted that persons on antipsychotic
medications or multiple medications would have a higher degree of measured tardive
dyskinesia than those on anti-epileptics or experimental controls, was partially
supported. Participants receiving traditional antipsychotic medications displayed
significantly more symptoms of tardive dyskinesia than all other groups. Individuals
receiving multiple medications displayed higher levels o f measured side effects than
each group except those persons receiving traditional antipsychotics. Findings
concerning persons on atypical antipsychotics were of note. This group displayed more
measured side effects than experimental controls on no medication, but the group did
not differ from persons receiving only anti-epileptic medications. As mentioned earlier,
persons receiving atypical antipsychotics displayed significantly less measured side-
effects than persons receiving traditional antipsychotics or multiple medications. Each
of these findings will be discussed more completely in the text that follows.
There is an extensive research base concerning the use of traditional
antipsychotic medications and significant side effects, and most studies indicate that
extended use of these medications is linked to a higher prevalence of tardive akithesias
and dyskinesias, flattened mood and affect, lower levels o f social and adaptive skills,
and depleted learning (Dent, 1995; Diaz, 1996; Cohen et al., 1998; Brasic & Barnett,
77
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
1997). Despite the prevalence of side-effects, these medications are known to be
effective in the treatment o f psychoses and manic symptoms that are treatment resistant
to traditional mood stabilizers. Therefore, there is certainly a need for this class of
medication in the treatment of psychiatric illness. However, a number of considerations
might be made before traditional antipsychotics are prescribed. First, clinicians should
consider if the presenting condition is one that might respond equally well to a
medication regime that causes less side effects. If it is, in fact, the case that traditional
antipsychotics are indicated, then treatment teams should insure that effective methods
o f measuring social skills, learning, and deleterious side-effects are used on a regular
basis. These data, in conjunction with measures o f the prevalence of psychiatric
symptoms, are essential for making decisions about medication effectiveness and
titration schedules.
Unfortunately for persons with mental retardation, the most frequent reason for
use of traditional antipsychotic medication is the presence of aggression or self-
injurious behavior. Though this class is not indicated as effective for the conditions, it
is frequently employed as a means o f suppressing aberrant behavior. While traditional
antipsychotics at significant doses might successfully suppress repertoires of
maladaptive behavior, the end result is normally suppression of the entire behavioral
repertoire leading to decreased learning, less social and adaptive behavior, and higher
prevalence o f side effects that can be debilitating if not life threatening. As a result,
traditional antipsychotics should be used as a first line behavioral intervention only in
those rare cases where traditional behavioral techniques (skills training, time-out,
78
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
reinforcement paradigms) and other, less sedating medications have proven ineffective
in managing the condition in question.
The current findings concerning atypical antipsychotic medication and side
effects are both interesting and encouraging. This class of medication, which is still
relatively new for American consumers, was marketed on the strengths of causing fewer
side effects while treating both positive and negative symptoms of psychosis. While the
latter portion of this marketing strategy remains an empirical question, the current data
lend initial support to the notion that individuals receiving atypical antipsychotics
display a lower prevalence of tardive dyskinesia. However, these data must be
interpreted with caution. Early results from unpublished European studies indicate that
after 3 to 5 years of use, the difference in prevalence of tardive dyskinesia between
atypical and traditional antipsychotics is not statistically or clinically significant. As
clinicians and researchers it is important to lend credence to these reports, as the
atypical class has been in use in Europe for a significantly longer time than in the
United States. Nonetheless, the current data are worthy of facilitating further research
in the area.
Although the current results did not indicate a high prevalence o f measured side-
effects resulting from use of anti-epileptic medications, this class warrants considerable
discussion with regard to causing debilitating conditions. The side-effects measure
selected for this investigation targeted mainly those symptoms synonymous with tardive
dyskinesia. The manner in which the anti-epileptic class affects physiological and
central nervous system functioning differs significantly from the action mechanisms of
79
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
the antipsychotic classes. Therefore, it is expected that anti-epileptics would not result
in significant symptoms of tardive dyskinesia. However, these medications cause a
number o f conditions that can affect learning, social performance, and physiological
functioning. Besides the agitation, sedation, and GI difficulties often associated with
anti-epileptic medication, this class is also known to cause major changes in platelet
counts and can result in life threatening conditions, such as thrombocytopenia (Trannel
et al., 2001). As a result, these medication warrant the same, careful monitoring as the
other classes used for behavioral and psychiatric stabilization. Measure o f social and
adaptive skills, learning, specific psychiatric symptoms, client reports of side-effects or
illness, and regular laboratory investigations should be the minimum in protocols
evaluating effectiveness and side-effects o f anti-epileptic medications.
In summarizing, each class of psychotropic medication results in prevalent but
different profiles o f negative side-effects. Treatment teams must be aware of all facets
involved with particular classes o f psychotropic medications in order to make
responsible treatment decisions for clients in their care.
The final hypothesis, that social and adaptive skills were sensitive to medication
class and time, was supported by the current data. Individuals receiving either
traditional antipsychotic medications, atypical antipsychotic medications, or medication
regimes containing either traditional or atypical antipsychotics and a mood stabilizer
demonstrated significantly less social and adaptive skills after receiving the medication
a minimum o f three years. Individuals receiving antiepileptic medications and
experimental controls did not experience significant change in measured skills over the
80
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
same period o f time, but instead remained mostly stable over the three year period of
measurement. Interestingly, the absence of antipsychotic medication for the latter two
groups did not facilitate or ensure acquisition o f new skills. This finding may indicate
that lack o f effective programming as well as the presence or absence of antipsychotic
medications is a variable o f extreme interest in evaluating the development o f new
social and adaptive skills.
A number of pertinent factors are involved with the extended use of
antipsychotic medication in persons with mental retardation. Persons in the population
who receive these classes o f medication, be it for behavioral or psychiatric stabilization,
tend to receive the medication for many years. Most subjects in this study who have
received the atypical class for the last three years had a history of traditional
antipsychotic use before medications were changed. The implications of extended use
on skill level and learning are significant. Research has consistently demonstrated that
long term use of antipsychotic medications often results in irreversible changes in the
central nervous system and neurochemical functioning (Kieman et al., 1995). These
changes often result in increased side-effects, decreased learning, and chronic
oversedation, which are conditions that can certainly affect the acquisition and
performance o f social and adaptive skills. Additionally, chronic use of antipsychotic
medication often perpetuates a vicious cycle o f continued medication use at increased
doses. Once changes in central nervous system functioning occur as a result o f
antipsychotic medication, the individual in question invariably requires the medication
to maintain a baseline level o f functioning. Therefore, the probability o f increased side
81
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
effects, decreased learning, and oversedation increases exponentially, resulting in lower
levels of social and adaptive functioning.
Finally, the age of the individual in question did not predict performance on
measures of social and adaptive skills. One might expect that persons who were older
with prolonged histories medication usage would perform lesser on measures o f social
and adaptive skills. However, research in the area of mental retardation and
antipsychotic medication indicates that a 3 to 5 year trial o f a particular medication, and
not the age or medication history of the individual in question, is the best predictor of
unfavorable side-effects and decreased skill level (Singh et al., 1993; Rubin, 1997).
These new findings support past conclusions and reaffirm the need for valid diagnostic
practices, conservative prescribing practices, and ongoing measures o f learning and
adverse side effects in persons with mental retardation who receive antipsychotic
medication.
Synopsis
The significance of the present study is in identifying the effect of psychotropic
medications on social skills, adaptive functioning, and levels o f measured side effects.
The current results indicated clearly that persons receiving more potent, sedating
psychotropic medications exhibit lower levels of social and adaptive skills than persons
on less potent or no medications. Additionally, length of time on particular classes of
medication dictates deterioration in performance of prosocial skills. Finally, the current
work demonstrated the need for constant monitoring o f learning, skill level, and
deleterious side effects in persons receiving any class o f mood or behavior altering
82
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
medication. Although side-effects profiles differ depending on the prescribed
medication, each class of medication can cause individuals to experience physiological
distress and a decline in skill level.
The current study has implications for clinicians and researchers alike.
Treatment teams should be aware o f the cost and benefits associated with each class o f
medication in order to make responsible treatment decisions. In those cases where
medication is clearly warranted, teams must use standardized assessment instruments to
ensure that medications are not resulting in suppression o f the total behavioral
repertoire or causing the individual in question unwarranted physiological distress.
For researchers, the implications o f the current study are numerous. Many
questions remain about the use o f psychotropic medications in persons with profound
mental retardation. Most of the research that currently exists in the area is extremely
methodologically flawed (Matson et al., in press); therefore, a need exists for a number
o f studies concerning medication effectiveness, medication effect on prosocial behavior,
medication use in conjunction with other treatment techniques, and side-effects profiles
resulting from medication use in persons with profound mental retardation. It is hoped
that results similar to those found in the current study will result in better treatment
decisions and improved quality o f life for persons with mental retardation. However,
current research protocols and methods of treatment do not suggest that a trend shift to
more responsible and conservative prescribing practices is likely in the near future.
83
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
REFERENCES
Aman, M.G. & Singh, N.N. (1983). Pharmacological intervention. InJ.L. Matson & J.A. Mulick, eds., Handbook o f Mental Retardation. New York: Pergamon.
Andrasik, F., & Matson, J.L. (1984). Social skills with the mentally retarded.In M.A. Milan and L.L. ‘Abate (eds.), Handbook o f Social Skills Training and Research. New York: John Wiley and Sons.
APA (1952). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.
APA (1968). Diagnostic and Statistical Manual of Mental Disorders. Second Edition. Washington, DC: American Psychiatric Association.
APA (1994). Diagnostic and Statistical Manual o f Mental Disorders. Fourth Edition. Washington, DC: American Psychiatric Association.
Arthur, G. (1947). Pseudo-feeblemindedness. American Journal of Mental Deficiency. 52. 137-142.
Barak, Y., Ring, A., Levy, D., Granek, I., Szor, H., & Elizur, A. (1995). Disabling compulsions in 11 mentally retarded adults: An open trial of clomipramine. Journal o f Clinical Psychiatry. 56 .459-461.
Baumeister, A. A. & Sevin, J.A. (1990). Pharmacologic control of aberrant behavior in the mentally retarded: Toward a more rational approach. Neuroscience & Biobehavioral Reviews. 14. 253-262.
Baumeister, A.A., Todd, M.E., & Sevin, J.A. (1993). Efficacy and specificity of pharmacologic therapies for behavioral disorders in persons with mental retardation. Clinical Neuropharmacologv. 16. 271-294.
Beale, I., Smith, O., & Webster, D. (1993). Effects of chlorpromazine and thioridazine on discrimination learning in children with mental retardation. Journal of Developmental and Physical Disabilities. 5 .43-54.
Bell-Dolan, D.J., Reaven, N., & Peterson, L. (1993). Depression and social functioning: A multidimensional study of the linkages. Journal o f Clinical Child Psychology. 22. 306-315.
Bellack, A.S. (1979). A critical appraisal of strategies for assessing social skill. Behavioral Assessment. 1 .157-176.
84
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Benjamin, E., & Bout-Smith, T. (1993). Naltrexone and fluoxetine in Prader- Willi syndrome. Journal of the American Academy of Child and Adolescent Psychiatry. 32. 870-873.
Benjamin, E., Seek, A., Tresise, L., Price, E., & Gagnon, M. (1995). Case study: Paradoxical response to naltrexone treatment of self-injurious behavior. Journal o f the American Academy of Child and Adolescent Psychiatry. 34. 238-242.
Bernstein, G. (1981). Research issues in training interpersonal skills for the mentally retarded. Education and Training of the Mentally Retarded. 16. 70-74.
Bodfish, J.W., & Madison, J.T. (1993). Diagnosis and fluoxetine treatment of compulsive behavior disorder of adults with mental retardation. American Journal on Mental Retardation. 98. 360-367.
Borthwick-Duffy, S.A. (1994). Epidemiology and prevalence of psychopathology in people with mental retardation. Journal o f Consulting and Clinical Psychology. 62. 17-27.
Brasic, J.R. & Bamett, J.Y. (1997). Hyperkinesias in a prepubertal boy with autistic disorder treated with haloperidol and valproic acid. Psychological Reports. §0, 163-170.
Brasic, J.R., Bamett, J.Y., Kaplan, D., Sheitman, B.B., Aisemberg, P., Lafargue, R.T., Kowalik, S., Clark, A., Tsaltas, M.O., & Young, J.G. (1994). Clomipramine ameliorates adventitious movements and compulsions in prepubertal boys with autistic disorder and severe mental retardation. Neurology. 44. 1309-1312.
Bullock, J.R. (1992). Children without friends: Who are they and how can teachers help? Childhood Education. 6 9 .92-96.
Bullock, M.J., Ironsmith, M., & Poteat, G.M. (1988). Sociometric techniques in young children: A review of psychometrics and classification schemes. School Psychology Review. 17. 289-303.
Buzan, R.D., Dubovsky, S.L., Treadway, J.T., & Thomas, M. (1995). Opiate antagonists for recurrent self-injurious behavior in three mentally retarded adults. Psychiatric Services. 46. 511-512.
85
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Carpenter, M., Cowart, C.A., McCallum, R.S., & Bell, S.M. (1990). Effects o f antipsychotic medication on discrimination learning for institutionalized adults who have mental retardation. Behavioral Residential Treatment, i , 105-120.
Chadsey-Rusch, J. (1992). Toward defining and measuring social skills in employment settings. American Journal of Mental Retardation. 96.405-418.
Christoff, K.A., & Kelly, J.A. (1983). Social skills. In J.L. Matson and S.E. Breuning (Eds.), Assessing the mentally retarded (pp. 181-206). New York: Grune and Stratton.
Christoff, K.A., & Kelly, J.A. (1985). A behavioral approach to social skills training with psychiatric patients. In L. L’abate & M. Milan (Eds.), Handbook of social skills training and research (pp. 361-387). New York: John Wiley and Sons.
Cohen, S. A., Ihrig, K., Lott, R. S., & Kerrick, J. M. (1998). Risperidone for aggression and self-injurious behavior in adults with mental retardation. Journal of Autism and Developmental Disorders. 28. 229-233.
Combs, M.L., & Slaby, D.A. (1977). Social skills training with children. In B.B. Lahey & A.E. Kazdin (Eds.), Advances in Child Clinical Psychology (Vol. 1, pp. 161-201). New York: Plenum Press.
Conger, J.C., & Conger, A.J. (1986). Assessment o f social skills. In A.R. Ciminero, K.S. Calhoun, & H.E. Adams (Eds.), Handbook of Behavioral Assessment (Vol. 2, pp. 526-560). New York: John Wiley and Sons.
Cook, E.H., Rowlett, R., Jaselskis, C., & Leventhal, B.L. (1992). Fluoxetine treatment o f children and adults with autistic disorder and mental retardation. Journal o f the American Academy o f Child and Adolescent Psychiatry, 21, 739-745.
Crews, W.D., Bonaventura, S., & Rowe, F.B. (1993). Cessation o f long-term naltrexone for self-injury: A case study. Research in Developmental Disabilities. J4, 331-340.
Curran, J.P. (1977). Skills training as an approach to the treatment of heterosexual-social anxiety: A review. Psychological Bulletin. 84. 140-157.
Davanzo, P.A., Belin, T.R., Widawski, M.H., & Bryan, H.K. (1998).Paroxetine treatment o f aggression and self-injury in persons with mental retardation. American Journal on Mental Retardation. 1Q2,427-437.
86
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Denicola, J., & Sandler, J. (1980). Training abusive parents in child management and self-control skills. Behavior Therapy. 11. 263-270.
Dent, J. (1995). Catatonic syndrome following recovery from neuroleptic malignant syndrome. Journal of Intellectual Disability Research. 29,457-459.
Diaz, S.F. (1996). Mania associated with resperidone use. Journal of Clinical Psychiatry, 5 1 ,41-42.
Doll, E. A. (1935). The measurement of social competence. Journal of Psycho- Asthenics. 40. 103-126.
Doll, E.A. (1936). Current thoughts on mental deficiency. Journal o f Psvcho- Asthenics. 41. 32-49.
Doll, E.A. (1941). The essentials o f an inclusive concept o f mental deficiency. American Journal o f Mental Deficiency, 46.214-219.
Dosen, A. (1993). Diagnosis and treatment o f psychiatric and behavioural disorders in mentally retarded individuals: The state o f the art. Journal o f Intellectual Disability Research. 37. S 1 -7.
Duncan, P.M., & Millard, W. (1866). A Manual for the Classification. Training, and Education of the Feeble-Minded. Imbecile, and Idiotic. London: Longmans, Green, & Co.
Editorial Board o f the APA Division 33. (1996). Definition o f Mental Retardation. In J.W. Jacobson and J.A. Mulick (Eds.), Manual of Diagnosis and Professional Practice in Mental Retardation. Washington, DC: American Psychological Association.
Eisler, R. M., Miller, P.M., Hersen, M., & Alford, H. (1974). Effects of assertive training on marital interaction. Archives o f General Psvchiatrv. 30. 643-649.
Elliot, S.N., & McKinnie, D.M. (1994). Relationships and differences among social skills, problem behaviors, and academic competence for mainstreamed learning disabled and nonhandicapped students. Canadian Journal o f School Psychology. 1 0 .1- 14.
Farrar-Schneider, D. (1995). The development o f the Measure of Observable Social Skills (MOSS). Louisiana State University: Unpublished doctoral dissertation.
87
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Fingeret, A.L., Monti, P.M., & Paxson, M. (1983). Relationships among social perception, social skill, and social anxiety in psychiatric patients. Psychological Reports. 53. 1175-1178.
Foster, S.L., & Ritchey, W.L. (1979). Issues in the assessment of social competence in children. Journal o f Applied Behavior Analysis. 12. 625-638.
Garber, H.J., Mcgonigle, J.J., Slomka, G.T., & Monteverde, E. (1992). Clomipramine treatment o f stereotypic behaviors and self-injury in patients with developmental disabilities. Journal of the American Academy of Child and Adolescent Psychiatry. 21, 1157-1160.
Garcia, D. & Smith, R.G. (1999). Using analog baselines to assess the effects of naltrexone on self-injurious behavior. Research in Developmental Disabilities. 2Q, 1- 21.
Gedye, A. (1998). Neuroleptic induced dementia documented in four adults with mental retardation. Mental Retardation. 26, 182-186.
Gettinger, M., & Kratochwill, T.R. (1987). Behavioral assessment. InC.L. Frame and J.L. Matson (Eds.), Handbook o f Assessment in Childhood Psychopathology (pp. 131-161). New York: Plenum Press.
Ghaziuddin, M., Tsai, L.Y., & Ghaziuddin, N. (1992). Haloperidol treatment of trichotillomania in a boy with autism and mental retardation. Journal o f Autism and Developmental Disorders. 21, 365-371.
Goddard, H.H. (1921). Abnormal Psychology and the study of the subnormal mind. Journal of Abnormal Psychology. 5 4 .47-50.
Goddard, H.H. (1928). Feeblemindedness: A question of definition. Journal of Psvcho-Asthenics. 33 .219-227.
Gordon, C.T., Rapoport, J.L., Hamburger, S.D., State, R.C., & Mannheim, G.B. (1992). Differential response o f seven subjects with autistic disorder to clomipramine and desipramine. American Journal o f Psychiatry. 142,363-366.
Greenspan, S., & Granfield, J.M. (1992). Reconsidering the construct o f mental retardation: Implications o f a model o f social competence. American Journal on Mental Retardation. 96. 442-453.
Greenspan, S., & Shoultz, B. (1981). Why mentally retarded adults lose their jobs: Social competence as a factor of work adjustment. Applied Research in Mental Retardation. 2 .23-38.
88
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Gresham, F.M. (1981). Assessment o f children’s social skills. Journal of School Psychology. 19.120-133.
Gresham, F.M. (1986a). Conceptual and definitional issues in the assessment of children’s social skills: Implications for classification and training. Journal of Clinical Child Psychology. 15. 3-15.
Gresham, F.M. (1986b). Conceptual issues in the assessment o f social competence in children. In P. Strain, M. Guralnick, and H. Walker (Eds.), Children’s social behavior: Development, assessment, and modification (pp. 143-186). New York: Academic Press.
Gresham, F.M. & Cavell, T.C. (1987). Assessment o f adolescent social skills. In R.G. Harringtion (Ed.), Testing Adolescents. Kansas City, MO: Test Corporation of America.
Gresham, F.M.,& Elliot, S.N. (1987). The relationship between adaptive behavior and social skills: Issues in definition and assessment. The Journal of Special Education. 21. 167-181.
Gresham, F.M., MacMillan, D.L., & Siperstein, G.N. (1995). Critical analysis o f the 1992 AAMR definition: Implications for school psychology. School Psychology Quarterly. 10.1-19.
Gresham, F.M., & Reschly, D.J. (1988). Issues in the conceptualization, classification, and assessment of social skills in the mildly handicapped. In T. Kratochwill (Ed.), Advances in school psychology (pp. 203-247). Hillsdale, NJ: Lawrence Erlbaum.
Gresham, F.M., & Stuart, D. (1992). Stability of sociometric assessment: Implications for uses as selection and outcome measures in social skills training.Journal of School Psychology. 30 .223-231.
Gross, E.J., Hull, H.G., Lytton, G.J., Hill, J.A., & Piersel, W.C. (1993). Case study of neuroleptic induced akithisia: Important implications for individuals with mental retardation. American Journal on Mental Retardation. 98. 156-164.
Grossman, H.J. (Ed.). (1973). Manual on Terminology and Classification in Mental Retardation. Washington, DC: American Association on Mental Retardation.
Grossman, H.J. (Ed.). (1977). Manual on Terminology and Classification in Mental Retardation. Washington, DC: American Association on Mental Retardation.
89
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Grossman, H.J. (Ed.). (1983). Manual on Terminology and Classification in Mental Retardation. Washington, DC: American Association on Mental Retardation.
Hammock, R. G., Schroeder, S. S., & Levine, W. R. (1995). The effect of clozapine on self-injurious behavior. Journal o f Autism and Developmental Disorders. 25,611-626.
Hanzel, T.E., Kalachnik, J.E., & Harder, S.R. (1992). A case o f phenobarbital exacerbation o f a preexisting maladaptive behavior partially suppressed by chlorpromazine and misinterpreted as chlorpromazine efficacy. Research in Developmental Disabilities. 12, 381 -392.
Hardan, A., Johnson, K., Johnson, C., & Hrecznyj, B. (1996). Case study: Risperidone treatment o f children and adolescents with developmental disorders.Journal o f the American Academy of Child and Adolescent Psychiatry. 35. 1551-1556.
Heber, R. (1959). Manual on terminology and classification in mental retardation. American Journal of Mental Deficiency. 64. Monograph supplement.
Heber, R. (1961). A Manual on Terminology and Classification in Mental Retardation. Washington, DC: American Association on Mental Deficiency.
Helsel, W.J., & Matson, J.L. (1984). The relationship of depression to social skills and intellectual functioning in mentally retarded adults. Journal of Mental Deficiency Research. 32.411-418.
Hill, B.K., Balow, E.A., & Bruininks, R.H. (1985). A national study of prescribed drugs in institutions and community residential facilities for mentally retarded people. Psychopharmacologv Bulletin. 21,279-284.
Horrigan, J. P. & Barnhill, L. J. (1997). Risperidone and explosive aggressive autism. Journal o f Autism and Developmental Disorders. 27. 313-323.
Horrigan, J. P. & Barnhill, L. J., & Courvoisie, H. E. (1997). Olanzapine in PDD. Journal o f the American Academy of Child and Adolescent Psychiatry. 3 6 .1166.
Hover, S., & Gaflhey, L.R. (1981). The relationship between social skills and adolescent drinking. Alcohol and Alcoholism. 26. 207-214.
Howland, R.H. (1996). Chlorpromazine and obsessive-compulsive symptoms. American Journal of Psychiatry. 153. 1503-1504.
90
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Humphrey, E.J. (1936). Development deficiencies as the essential problem in mental deficiency. Journal o f Psvcho-Asthenics. 41. 215-224.
Kanner, L. (1948). Feeblemindedness: Absolute, relative, and apparent. The Nervous Child. 7. 365-397.
Kanner, L. (1964). A History o f the Care and Study of the Mentally Retarded. Springfield, 1L: Charles C. Thomas.
Kazdin, A.E., & Matson, J.L. (1981). Social validation in mental retardation. Applied Research in Mental Retardation. 2.39-53.
Kennedy, J.H. (1988). Issues in the identification o f socially incompetent children. School Psychology Review. 17. 276-288.
Kieman, C., Reeves, D., & Alborz, A. (1995). The use of antipsychotic drugs with adults with learning disabilities and challenging behaviour. Journal o f Intellectual Disability Research. 29,263-274.
Kuhlman, F. (1941). Definition of mental deficiency. American Journal of Mental Deficiency. 46.206-213.
Langee, H.R. & Conlon, M. (1992). Predictors o f responses to antidepressant medicatons. American Journal on Mental Retardation. 97, 65-70.
LeBlanc, L. (1996). Social skills in adults with severe disabilities. Louisiana State University: Unpublished doctoral dissertation.
Lewis, E.O. (1933). Types o f mental deficiency and the social significance. Journal of Mental Science. 79. 298-304.
Lewis, M.H., Bodfish, J.W., Powell, S.B., & Golden, R.N. (1995). Clomipramine treatment for stereotypy and related repetitive movement disorders associated with mental retardation. American Journal on Mental Retardation. 100. 299- 312.
Libet, J.M., & Lewinsohn, P.M. (1973). Concept o f social skills with special reference to the behavior o f depressed persons. Journal o f Consulting and Clinical Psychology. 40.304-312.
Lobitz, W.C., & LoPiccolo, J. (1972). New methods in the behavioral treatment of sexual dysfunction. Journal o f Behavior Therapy and Experimental Psychiatry. 3. 275-281.
91
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Lovett, D.L., & Harris, M.B. (1987). Identification o f important community living skills for adults with mental retardation. Rehabilitation Counseling Bulletin. 31. 34-41.
Lowe, M.R. (1985). Psychometric evaluation o f the Social Performance Survey Schedule: Reliability and validity of the positive behavior subscale. Behavior Modification. 9. 193-210.
Lowe, M.R. & Cautela, J.R. (1978). A self-report measure of social skill. Behavior Therapy. 9. 535-544.
Luckasson, R., Coulter, D.L., Polloway, E.A., Reiss, S., Schalock, R.L., Snell, M.E., Spitalnik, D.M., & Stark, J.A. (1992). Mental Retardation: Definition. Classification, and Systems of Support. Washington, DC: American Association on Mental Retardation.
Marchetti, A.G., & Campbell, V.A. (1990). Social skills. In J.L. Matson (Ed.), Handbook of behavior modification with the mentally retarded (2nd ed., pp. 333-355). New York: Plenum Press.
Marglait, M. (1991). Promoting classroom adjustment and social skills for students with mental retardation within an experimental and control group design. Exceptionality. 2. 195-204.
Matson, J.L. (1995a). Comments on Gresham, MacMillan, and Siperstein’s paper “Critical analysis of the 1992 AAMR definition: Implications for school psychology”. School Psychology Quarterly. 10. 20-23.
Matson, J.L. (1995b). Matson Evaluation o f Social Skills for Individuals with sEvere Retardation (MESSIER). Baton Rouge: Scientific Publishers, Inc.
Matson, J.L., Bamburg, J.W., Mayville, E., Pinkston, J., Bielecki, J., Kuhn, D., Smalls, Y., & Logan, J.R. (In press). Psychopharmacology and mental retardation: A 10 year review. Research in Developmental Disabilities.
Matson, J.L., Carlisle, C.B., & Bamburg, J.W. (1998). The convergent validity of the Matson Evaluation of Social Skills in Individuals with sEvere Retardation (MESSIER). Research in Developmental Disabilities. 19.493-500.
Matson, J.L., Compton, L.S., & Sevin, J.A. (1991). Comparison and item analysis o f the MESSY for autistic and normal children. Research in Developmental Disabilities. 12.361-369.
92
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Matson, J.L., & Hammer, D. (1996). Assessment of social functioning. InJ.W. Jacobson & J.A. Mulick, (Eds.), Manual o f Diagnosis and Professional Practfcsiii Mental Retardation. Washington, DC: American Psychological Assocation.
Matson, J.L., Helsel, W.J., Bellack, A.S., & Senatore, V. (1983). Development of a rating scale to assess social skill deficits in mentally retarded adults. Applied Research in Mental Retardation. 4. 399-407.
Matson, J.L., Kazdin, A.E., & Senatore, V. (1984). Psychometric properties of the Psychopathology Instrument for the Mentally Retarded Adults (P1MRA). Applied Research in Mental Retardation. 5. 81-89.
Matson, J.L., & Ollendick, T.H. (1988). Enhancing children’s social skill: Assessment and training. New York: Pergamon Press.
Matson, J.L., Smiroldo, B.B., & Bamburg, J.W. (1998). The relationship of psychopathology to social skills in persons with severe and profound mental retardation. Journal oflntellectual Disability Research. 23.137-145.
May, P., London, E.B., Zimmerman, T., & Thompson, R. (1995). The study of the clinical outcome of patients with profound mental retardation gradually withdrawn from chronic neuroleptic medication. Annals of Clinical Psychiatry. 2,155-160.
McCord, J„ Tremblay, R.E., Vitaro, F., & Desmarais-Gervais, L. (1994). Boys’ disruptive behaviour, school maladjustment, and delinquency: The Montreal prevention experiment. International Journal of Behavioral Development. 17. 739-752.
McDougle, C. J., Holmes, J. P., Bronson, M. R., Anderson, G. M., Volkmar, F. R., Price, L. H., & Cohen, D. J. (1997). Risperidone treatment o f children and adolescents with pervasive developmental disorders: A prospective, open-label study. Journal of the American Academy of Child and Adolescent Psychiatry. 3 6 .685-693.
McDougle, C. J., Holmes, J. P., Carlson, D. C., Pelton, G. H., Cohen, D. J., & Price, L. H. (1998). A double-blind, placebo-controlled study o f risperidone in adults with autistic disorder and other pervasive developmental disorders. Archives of General Psychiatry. 5 5 .633-641.
McFall, R.M. (1982). A review and reformulation o f the concept o f social skills. Behavioral Assessment. 9. 361-377.
McFall, R.M., & Littlesand, D.B. (1971). Behavior rehearsal with modeling and coaching in assertion training. Journal of Abnormal Psychology. 77. 313-323.
93
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Meyer, L.H., Cole, D.A., McQuarter, R., & Reichle, J. (1990). Validation of the assessment o f social competence (ASC) for children and young adults with developmental disabilities. Journal of the Association for Persons with Severe Handicaps. 15. 57-68.
Miller, L.S., & Funabiki, D. (1984). Predictive validity of the Social Performance Survey Schedule for component interpersonal behaviors. Behavioral Assessment. 6. 33-44.
Mueser, K.T., & Bellack, A.S. (1998). Social skills and social functioning. In K.T. Mueser & N. Tarrier (Eds.), Handbook of Social Functioning in Schizophrenia. Boston: Allyn & Bacon.
Myers, B.A. & Pueschel, S.M. (1994). Brief report: A case o f schizophrenia in a population with down syndrome. Journal o f Autism and Developmental Disorders.24, 95-98.
Nicholson, R., Awad, G., & Sloman, L. (1998). An open trial o f risperidone in young autistic children. Journal o f the American Academy o f Child and Adolescent Psychiatry. 37. 372-376.
Niije, B. (1969). The normalization principle-Implications and comments. Journal o f Mental Subnormalitv. 16.62-70.
Paclawskyj, T.R., Rush, K.S., Matson, J.L., & Cherry, K.E. (1999). Factor structure o f the Matson Evaluation of Social Skills for Individuals with sEvere Retardation (MESSIER). British Journal o f Clinical Psychology. 38. 289-293.
Perry, N. (1960). Teaching the Mentally Retarded Child. New York: Columbia University Press.
Phillips, E.L. (1985). Social skills: history and prospect. In L. L’abate and M. Milan (Eds.), Handbook of social skills training and research (pp. 3-21). New York: John Wiley & Sons.
Potenza, M. C., Holmes, J. P., Kanes, S. J., & McDougle, C. J. (1999). Olanzapine treatment o f children, adolescents, and adults with Pervasive Developmental Disorders: An open-label pilot study. Journal o f Clinical Psychopharmacologv. 19. 37-44.
Purdon, S. E., Lit, W., Labelle, A., & Jones, B. D. W. (1994). Risperidone in the treatment o f Pervasive Developmental Disorder. Canadian Journal o f Psychiatry. 22,400-405.
94
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Rosenquist, P.B., Bodfish, J.W., & Thompson, R. (1997). Tourette syndrome associated with mental retardation: A single subject treatment study with haloperidol. American Journal on Mental Retardation. M l, 497-504.
Rubin, M. (1997). Use o f atypical antipsychotics in children with mental retardation, autism, and other developmental disabilities. Psychiatric Annals. 27. 219-221 .
Ruedrich, S., Swales, T.P., Fossaceca, C.,Toliver, J., & Rutkowski, A. (1999). Effect of divalproex sodium on aggression and self-injurious behavior in adults with intellectual disability: A retrospective review. Journal of Intellectual Disability Research, 41,105-1 u .
Rychlak, J.F., & Wade, I. (1963). American usage of the terms “educable” and “trainable” mental retardates. Journal o f Mental Submormalitv. 16. 70-75.
Sandman, C.A., Hetrick, W., Taylor, D.V., & Chicz-DeMet, A. (1997). Dissociation of POMC peptides after self-injury predicts responses to centrally acting opiate blockers. American Journal on Mental Retardation. 102. 182-199.
Scheerenberger, R.C. (1982). A History o f Mental Retardation. Baltimore: Brookes Publishing Company.
Scotti, J.R., Evans, I.M., Meyer, L.H., & Walker, P. (1991). A metanalysis o f intervention research with problem behavior: Treatment validity and standards of practice. American Journal on Mental Retardation. 9£, 233-256.
Scotti, J.R., Schulman, D.E., & Hojnacki, R.M. (1995). Functional analysis and unsuccessful treatment o f Tourette’s syndrome in a man with profound mental retardation. Behavior Therapy. 21, 721-738.
Shure, M.B. (1981). Social competence as a problem solving skill. InJ.D. Wine and M.D. Smye (Eds.). Social competence (pp. 158-1851. New York: Guilford Press.
Sigafoos, J. (1995). Testing for spontaneous use o f requests after sign language training with two severely handicapped adults. Behavioral Interventions. 10. 1-16.
Singh, N.N., Ellis, C.R., Crews, D.W., & Singh, Y.N. (1995). Does diminished dopaminergic neurotransmission increase pica? Journal o f Child and Adolescent Psvchopharmacologv- 4, 93-99.
95
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Singh, N.N., Landrum, T.J., Ellis, C.R., & Donatelli, L.S. (1993). Effects of thioridazine and visual screening on stereotypy and social behavior in individuals with mental retardation. Research in Developmental Disabilities. 14. 163-177.
Siperstein, G.N. (1992). Social competence: An important construct in mental retardation. American Journal on Mental Retardation. 96. iii-vi.
Sovner, R & Hurley, A. (1981). The management o f chronic behavior disorders in mentally retarded adults with lithium carbonate. Journal o f Nervous and Mental Disturbance. 169. 191-195.
Sparrow, S.S., Balia, D.A., & Cicchetti, D.V. (1984). Vineland Adaptive Behavior Scales. Circle Pines, MN: American Guidance Service.
Spemer, U.B., Czeipek, I., Gaggl, S., Geissler, D., Speil, G., & Fleischhacker, W.W. (1998). Treatment o f severe clozapine induced neutropenia with granulocyte colony stimulating factor (G-CSF): Remission despite continuous treatment with clozapine. British Journal o f Psychiatry. 172, 82-84.
Suzuki, E., Knba, S., Nibuya, M., & Shintani, F. (1992). Use o f pimozide in the Pisa syndrome. American Journal of Psychiatry. 142,1114-1115.
Taylor, S.J., & Harris, S.L. (1995). Teaching children with autism to seek information: Acquisition o f novel information and generalization o f responding.Journal o f Applied Behavior Analysis. 28. 3-14.
Taylor, D.V., Hetrick, W.P., Touchette, N.P., Barron, J.L., & Sandman, C.A. (1991). Effect of naltrexone upon self-injurious behavior, learning, and activity: A case study. Pharmacology Biochemistry and Behavior. 4Q, 79-82.
Trannel, T.J., Ahmed, I., & Goebert, D. (2001). Occurrence o f thrombocytopenia in psychiatric patients taking valproate. American Journal of Psychiatry. 158. 128-130.
Tredgold, R.F. (1947). Mental Deficiency (7th Ed.L Baltimore: The Williams and Wilkins Co.
Trent, J.W., Jr. (1994). Inventing the Feeble Mind. Berkeley: University of California Press.
Van Hasselt, V., Hersen, M., & Milliones, J. (1978). Social skills training in alcoholics and drug addicts: A review. Addictive Behaviors. 3. 221-233.
96
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Volling, B.L., MacKinnon-Lewis, C., Rabiner, D., & Baradaran, L.P. (1993). Children’s social competence and sociometric status: Further exploration of aggression, social withdrawal, and peer rejection. Development and Psychopathology. 5.459-483.
Walters, A.S., Barrett, R.P., Feinstein, C., Mercurio, A., & Hole, W.T. (1990). A case report of naltrexone treatment o f self-injury and social withdrawal in autism. Journal o f Autism and Developmental Disorders. 20. 169-176.
Williemsen-Swinkels, S.H.N., Buitelaar, J.K., Nijhof, G.J., & van Engeland, H. (1995). Failure o f naltrexone hydrocholoride to reduce self-injurious and autistic behavior in mentally retarded adults. Archives in General Psychiatry. 52, 766-773.
Wolfensberger, W. (1970). A brief overview of the principle of normalization. In R.J. Flynn & K.G. Nitch, (Eds.), Normalization. Social Integration, and Community Services. Baltimore: University Press.
Wolfolk, W.B., Fucci, D., Gelzayd, J.F., & Manz, C.C. (1991). Social skills measurement o f the mentally impaired. Bulletin of the Psvchonomic Society. 29. 220-222.
Yepsen, L.N. (1941). Defining mental deficiency. American Journal o f Mental Deficiency. 46. 200-205.
97
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
APPENDIX
INSTITUTIONAL CONSENT TO CONDUCT RESEARCH
98
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
m u ia w S *
Edwin W . Edwards COVERNOR
STATE O F LOUISIANA DEPARTMENT O F HEALTH A N D HOSPITALS
December 14 , 1994
D « p * rtm « at •!M CA LTM **«HQ3HTAL3
Rose V. Fanes SECRETARY
Johnny L. Matson, Ph.D.L ou is iana S ta te U n iv e r s i ty 3333’Woodland Ridge B lvd.Baton Rouge, LA 70816
Dear Dr. Matson:
Your proposal Cor a r e s e a r c h p r o j e c t e n t i t l e d "Norming P sycho log ica l A ssessm en t B a t t e r y Cor Treatment P lans" has rece ived th e a p p ro v a l oC t h e P in e c re s t Developmental C enter Human R ig h ts ' Com m ittee. Please submit the r e s u l t s oC t h i s s tu d y when i t i s completed to me Cor p re se n ta t io n to th e c o m m it te e .
Please notiCy me 1C any a s s i s t a n c e o r Curther in fo rm ation i s r e q u i r e d . Your c o o r d i n a t i o n oC t h i s v a lu ab le study i s g r e a t l y a p p r e c i a t e d .
S i n c e r e l y ,
" IC uMargaret campbgll L i a i s o n , Ad Hoc-1 Committee Human R ig h ts Committee